Nightmare of the Mind : Malarchuk Lives in a World Where Choices Are Driven, Not Made

SAN DIEGO — Time was when Clint Malarchuk was best known as the NHL goaltender who nearly bled to death on the ice.

On March 22, 1989, the skate of Steve Tuttle slashed Malarchuk's throat like a cutlass, severing the jugular vein. Malarchuk's blood formed a pool at his feet.

A red, ropy scar remains today, clinging like a leech to the right side of his neck, but Malarchuk came back from that incident. It used to be the one big life story for Malarchuk to retell.

Now, though, Clint Malarchuk is known as the NHL goaltender who got lost. The guy who had the problem. But no one can say exactly what it was that drove Malarchuk from the league after 10 years. That is what his problem is all about: secrecy, shame, misunderstanding and daily struggle.

A year ago, Malarchuk, 31, was found to have obsessive-compulsive disorder, a seldom talked-about but increasingly common malfunction of brain chemistry. OCD is what drove Malarchuk from the NHL to the San Diego Gulls of the International Hockey League. OCD is also what has robbed him of his most precious possession--peace of mind.

The life of an obsessive-compulsive is one of horrifying and immobilizing thoughts and the irresistible drive to perform routines and rituals, sometimes hundreds of times a day.

There are "checkers," people who may sleep only a few hours a night because they keep getting up to make sure the doors are locked and the lights are off. There are people whose dressing routine has them putting on and taking off their clothes dozens of times. Some are convinced that they cannot walk through a doorway without twirling a certain number of times. Hand washers. Hair pullers. Counters.

The behavior of those afflicted with obsessive-compulsive disorder is difficult to understand. Many mistake the habits of OCD for interesting quirks, but they aren't. The rituals and repetitions of OCD are not the same as those of a perfectionist. Their insistence on specific patterns and methods are not superstitions.

An obsessive person cannot control his or her thoughts. A compulsive person must act on the thoughts.

If it all sounds strange and frightening--and Malarchuk agrees that it does--consider that OCD is more common than asthma or diabetes. It's not often talked about, but one in 40 of us have it. Doctors are calling it the disease of the '90s.

Although the disease is called OCD, it is possible to be afflicted with only the obsessions--the thoughts--and not the compulsions, the actions. According to some doctors, treating the obsessive is more difficult. It is easier to break down the rituals of a compulsive than plumb the mind of an obsessive.

"How would you like to be forced not to think about a pink elephant?" asked Dr. Stephen Stahl, a professor in UC San Diego's psychiatry department and a specialist in the treatment of OCD. "You must not think about it. Of course, you do think about a pink elephant. You can't tell someone not to think about something. It's very difficult for these people to concentrate. They experience thoughts that are intrusive. They don't want them. It's more difficult to treat that than behavior."

Malarchuk has been living with, and hiding, the disease for most of his life. How he got through his 10 seasons with Quebec, Washington and Buffalo while struggling daily to control his thoughts is a tribute to both his love of hockey and, perhaps, his need to feel normal.

"I knew my thoughts and actions were not normal," Malarchuk said. "At times I thought I was crazy. There are (OCD) people with rituals that are beyond belief, that take them hours to perform. Yet they are able to work eight hours and put it on a shelf. That's what I was able to do. I would be terrible the day of a game, because the anxiety of the game increased the pressure. I would obsess so much easier. The night before a game it would start.

"Sometimes they give a goalie his own room. To me, that was the biggest relief in the world. I could do my preparation--which every goalie does, but in private. Pacing, acting out. Mine was a little excessive. You know what the funniest thing is? Goalies have this stigma attached to them that they are crazy and flaky. I've had more people tell me that I was the most normal goalie they'd ever met. Inside me I was saying, 'If you only knew.' "

Malarchuk saw the face of his disease in a violent and defining moment about a year ago.

By then, he obsessed all the time. It was as if he couldn't turn off his mind. He might be watching a movie on television in which a wife was being unfaithful to her husband. That would act as a powerful suggestion to Malarchuk. He would believe that his wife was being unfaithful--he would know it. No reassurance would satisfy him.

He could be driving down the road and hit a bump and be convinced that he had run over a pedestrian. Even doubling back and finding no body could not alleviate the real horror he felt.